Prevalence, intention to use, and factors associated with the decision to use contraceptives among Peruvian women aged 40 to 49 years

Introduction
The use of contraceptive methods (CM) in women aged 40 to 49 years is often underesti­mated, despite the risk of unplanned pregnancies. This study aimed to estimate the prevalence and associated factors of CM use among Peruvian women in this age group.

Material and methods
An analytical, cross-sectional study was conducted based on secondary data from the 2023 Demographic and Family Health Survey (ENDES). Women aged 40 to 49 years who were neither preg­nant nor menopausal were included. Sociodemographic, gynecologic-obstetric, and intimate partner violence variables were analyzed with adjustments for complex survey design.

Results
The prevalence of CM use was 63.06%. The most commonly used methods were female steriliza­tion (26.73%) and injectable contraceptives (15.46%). Contraceptive method use was higher among women aged 40–44 years, those who were married or cohabiting, and those with more children. Lower use was associ­ated with the desire for more children, lack of knowledge about the ovulatory cycle, and a history of intimate partner violence. Among women not using CM, 54.22% expressed an intention to use them in the future, mainly favoring injectable methods or condoms. The most frequent reasons for non-use were infrequent sexual activity, perceived infertility, and not being in a relationship.

Discussion
Contraceptive methods used in this group are influenced by personal, relational, and contextual factors. Violence and limited partner involvement negatively affect its adoption.

Conclusions
It is necessary to strengthen personalized counseling strategies, reduce gender inequalities, and promote shared contraceptive responsibility among women of advanced reproductive age.